Influence of the Anti-diabetic Substance 



69 



1922. The urinary sugar at this time reached its lowest point, 

 9.17 gms. Acetone was reduced about one half the former quan- 

 tity and diacetic acid was absent on fourteen of the eighteen 

 days treatment. 



The patient was transferred to his home July 31, 1922 and 

 kept at rest and on a diet consisting of carbohydrate 28.52 gms., 

 protein 76.16, fat 127.04, and total calories 1,900. No treatment 

 was given from July 29, 1922 to August 13, 1922. During this 

 time the blood sugar rose somewhat but did not return to the level 

 before treatment was started. The urinary sugar averaged 

 from 39 to 52 grams. The acetone and diacetic acid 1+. 



Forty-five injections were given subcutaneously during the 

 period from August 13, 1922 to October 13, 1922. From one to 

 three injections were given daily with occasional intermission. 

 Extracts secured by different methods were used. By means of 

 the subcutaneous method of injection, the blood and urine sugar, 

 acetone and diacetic acid were reduced to normal. The clinical 

 symptoms entirely disappeared. Marked reduction in blood 

 sugar was at times noted. On August 25, 1922 the blood sugar 

 was reduced from 0.320 to 0.200 six hours after a single in- 

 jection of the pancreatic extract. On September 9, 1922 the 

 blood sugar was reduced from 0.200 to 0.092, a reduction from 

 0.328 to 0.092 in twenty-three hours by four injections sub- 

 cutaneously. The blood sugar rose over night to 0.200. In six 

 hours by a single injection it was reduced to 0.070. The urinary 

 sugar, acetone and diacetic acid disappeared entirely. The diet 

 was increased to carbohydrate 50.52 gms., protein 119, fat 167, 

 and total calories 2,500. The urinary sugar, acetone and diacetic 

 acid remained absent. The blood sugar showed a slight rise. 



Some of the earlier injections showed some pain, local edema 

 and occasionally temporary redness. Only three of the forty- 

 five injections showed definite local reaction. Later injections 

 were non-toxic and non-irritating. Pain is no greater than can 

 be accounted for by tissue distention. 



Subcutaneous injections were discontinued October 4, 1922 

 and the extract given by mouth for two days. During the next 

 three days the extract was given in salol-coated capsules. Neither 

 method was plainly effective. 



Subcutaneous injections were again given and the blood and 

 urinary sugar were reduced. 



